Background: Soft tissue diagnosis in orthodontics plays an important role in treatment planning and the mechanics involved. Evaluation of nasolabial angle is considered to be an essential in orthodontic diagnosis and treatment planning. In this study, we would like to assess the normal range of nasolabial angle in the South Indian population. As the people in South Indian may present craniofacial characteristics which differ from those of other races, whose cephalometric analysis are usually considered as the standard in routine orthodontic diagnosis and treatment planning. Further studies are therefore needed to ensure values of optimal range for an accurate diagnosis for this group. The purpose of this study is to establish norms for evaluation of nasolabial angle for the South Indian population.
Materials and Methods: 102 lateral cephalometric radiographs (41 males and 61 females) were collected from Tamil Nadu, Pondicherry, Andhra Pradesh, and Karnataka. The average age ranged between 18 and 28 years. The radiographs are manually traced, and the nasolabial angle, lower border of the nose to the FH plane (N/ FH), and upper lip to the FH plane (L/FH) of these subjects were measured and after statistical analysis results were obtained.
Results: The mean value of 99.76° with standard deviation (SD) ± 15.35° was established for the entire sample, no statistically significant difference was observed between male and female value, although males recorded a more obtuse nasolabial angle of 101.73° with SD ± 12.57 and the females who recorded 98° with SD ± 16.85.
Conclusion: The mean nasolabial angle of 99.76° with SD ± 15.35° was observed in the South Indian population, the sexual difference was not observed. However, the values obtained in this study differ from the studies reported for Caucasian and other racial group, but it is accordance with the other Asian population.

Background: The concept of bonding resins to enamel has enjoyed applications in all fields of dentistry, including the bonding of orthodontic brackets. In the process of bonding orthodontic brackets to enamel, conventional adhesive systems use three different agents: An enamel conditioner, a primer solution, and an adhesive resin. The bonded brackets should have enough bond strength to withstand masticatory forces, the forces applied during orthodontic treatment and should enable easy debonding, clean up procedure at the end of the treatment without causing iatrogenic damage such as cracks and loss of enamel. Depending on the mode and direction of the loading force different types of bond strengths are evident. Thus, the aim of the study is to evaluate the adhesive remnant index (ARI) of Metal-Chrome Cobalt TP Nu-edge L N bracket system with Primekote base and to compare it with that of 3M Gemini Metal-Stainless Steel bracket with woven mesh base and Ormco Metal-Stainless Steel bracket with the Optimesh base.
Materials and Methods: Three commercially available pre-adjusted edgewise premolar brackets with different base designs were used for the study on 54 premolar teeth. An optical microscope was used to determine the enamel crack after debonding. Scoring was done to calculate the ARI. Statistical analysis: Chi-square test was performed.
Results: Varying fracture sites were noted for 3M Gemini and TP Primekote brackets, with 44% of bond failure occurring at the bracket/adhesive interface. Ormco Optimesh brackets had bond failure site at bracket adhesive interface in about 66% of the samples. The difference in ARI scores noted was statistically significant. The bond failure for tensile bond strength test group occurred at the bracket/adhesive interface.
Conclusion: Sites of bond failure after tensile bond strength test was mostly at the bracket/adhesive interface or within the adhesive. None of the brackets showed failure at the enamel/adhesive interface. Hence, tensile stress can be used for debonding.

Molar intrusion has always been a complex and difficult treatment modality. It can be approached for treating open bite patients or over erupted molar tooth/teeth. Through the decades, various treatment strategies have been developed to intrude molar teeth, ranging from non-surgical to surgical approaches, and utilizing various appliances, some which rely on patient compliance. The aim of this article is to compile and summarize the existing molar intrusive techniques and appliances with respect to their advantages and disadvantages, and their possible clinical effectiveness.

Background: Removal of jaw cysts that reach large sizes, result in facial deformity, injury to the adjacent neurovascular bundles or jaw fracture. Marsupialization means creating a window into the cyst for decompression and is an adjuvant treatment. Limitations of this technique are not explained completely.
Materials and Methods: Patients suffering from a variety of jaw cysts that were managed by marsupialization with or without subsequent enucleation were included in this study between 2007 and 2014. At the 3rd and 6th month, follow-up radiographs were ordered.
Results: There were 16 patients (20 cysts) that were included in this study. There were two cases (2/16) that decision was made to change the treatment planning. Half the cysts were histologically proven odontogenic keratocyst. Two-thirds of the patients, who needs to enucleation subsequent to the successful marsupialization, were managed under general anesthesia.
Conclusion: Limitations of this technique are: Inability to examine the whole cyst microscopically, questionable eruption of the permanent tooth involved with the cyst, dependency on the patient cooperation, and difficulty of irrigation fluid circulation in multilocular jaw cysts, and finally, if the created window has large dimensions then soft tissue closure after final cyst enucleation is the problem.

Background: Probiotic bacteria are thought to reduce the risk of some infectious diseases. Recently, the probiotics and their effect on oral health have been a focus of numerous trials. The documented trials have been reported from developing countries, such as India, with its focus on pediatric population. This study was done to evaluate the effects of short term consumption of probiotic milk containing Lactobacillus casei Shirota, and its effects on the levels of salivary Streptococcus mutans in children.
Materials and Methods : A cross-sectional study was performed on 20 healthy subjects and was followed for 7 days. The assessment of S. mutans in saliva was done at baseline, 1 h after consumption of probiotic milk and after 7-day of intervention period using mitis salivarius bacitracin agar. The colonies of S. mutans were identified and counted using a digital colony counter.
Results: A statistically significant reduction of salivary S. mutans was recorded after consumption of the probiotic milk. The comparison between baselines versus follow-up salivary S. mutans count after consumption of probiotic milk was found to be statistically significant ( P ≤ 0.05).
Conclusion: Based on observations of this study - Short term consumption probiotic milk reduced the growth of salivary S. mutans levels. Efforts should be made to increase the awareness of the dental practitioners about this aspect of oral therapy and encourage the implementation of the concept of "food rather than medicine."

Lichen planus (LP) is a common chronic mucocutaneous disease of the skin and mucous membranes. It affects about 0.1-4% of the general population. Here, we present a case report of a 36-year-old female patient who presented with burning sensation and a white lesion bilaterally on the buccal mucosa along with a mixed red and white lesion on the tongue. The histopathological features were suggestive of oral LP (OLP). In this article, we try to evaluate the histopathological features of OLP and stress the eminence of mast cells (MCs) in the occurrence of OLP. We also try to review the literature behind the role of MCs, their significance and their effects on the histological picture of LP.

Background: Present study was aimed to access the effectiveness of herbal mouthwash against plaque and gingivitis agents as compared with standard chlorhexidine.
Materials and Methods: A total of 120 patients were chosen for the study with the age group of 18-30 years. The patients were divided into three groups. Group A included patients only on chlorhexidine mouthwash; Group B included patients on herbal mouthwash, and Group C included patients on distilled water. Turesky modification of Quigley-Hein plaque index and modified gingival index by Lobene were used to evaluate plaque and gingivitis, respectively.
Results: There was a significant reduction of dental plaque and gingival scores from 0 to 21 days in all the groups.
Conclusion: Herbal mouth users showed significant enhancement from 0 to 21 days in protecting and maintaining the oral health. However, due to side effects seen while long-term using chlorhexidine mouth rinse, herbal mouthwashes can be used as a replacement for chlorhexidine mouthwash.

Background: The objective of the study was to assess the relationship between psychological stress and its relation with oral health among tobacco user and non-user.
Materials and Methods: A hospital based study was conducted for 3 months among 1184 subjects visiting the outpatient department of Vyas Hospital in India. After obtaining institutional ethical clearance, a pretested proforma was used for data collection. Informed consent was taken from study subjects. Stress was measured by using modified Dental Anxiety Stress Scale (DASS). Frequency, percentage, and multinomial logistic regression analysis were performed using SPSS (version 16.0, Chicago, IL, USA). The level of significance was set at P ≤ 0.05.
Results: Subjects, who were having low income (28%) and low education (18.2%) status, were under high psychological stress as compared to other groups. It was also found that as the stress level was increasing dental caries (82.4%), gingival inflammation (88.4%), and periodontal disease (88.4%) were also increasing. From multiple logistic regression model, it was found that age, gender, income, and psychological stress had a significant effect on periodontal status and dental caries status among tobacco users.
Conclusion: Stressful life events are often presumed to be associated with dental disease progression hence it is important for clinician to recognize patients who are in stress and guide them about detrimental effects of stress on oral health along with routine dental treatment.

Background: The position of lips and the shape of the nose in the face have been considered as an important factor in determining the attractiveness of a person. The aim of this study was to evaluate the influences of the shape of dorsum of the nose on the perception of lip position and to determine whether there was any difference in the evaluation of lip position by different groups of people.
Materials and Methods: A series of profile photographs were developed using computer software for the evaluation of facial attractiveness from an average South Indian male and female profile. These photographs were presented in an album, and the evaluators were asked to select the best profile from each series to record the evaluator's perception of facial balance. Three different groups of evaluators assessed these pictures.
Results: A general public group selected more protrusive profiles for females than males. Clinicians and the general public tend to view facial esthetics differently, with the general public demonstrating the greatest variation in what they consider attractive.
Conclusion: The general public preferred more protrusive lips for females than males. The shape of nasal dorsum has an influence on the perception of lip position but only in the eye of the general public.

Background: Natural catastrophes account for maximum and most undesirable loss of mankind. Those individuals can be best represented by dental remnants. Body size is probably the single most important determinant of body architecture, physiology ecology, life history, and social organization in mammals. The weight and body mass index (BMI) can be used as a measure of body size. It is seen that the tooth crown area (crown length multiplied by crown width) increases in relation to the square of a linear dimension, whereas body weight, being proportional to volume, increases in relation to the cube of a linear dimension, assuming geometric similarity is maintained. Thus, one might predict theoretically that tooth area should increase or decrease as the 2/3 (or 0.67) power of body weight. BMI can be calculated from body weight and height of an individual. In this study, we tried to examine the relationship between tooth crown area and body weight and BMI of human individuals. To correlate the relationship of tooth crown area with body weight and BMI of human beings.
Materials and Methods: Study includes 60 individuals (30 males and 30 females) of 18-24 years of age group. Tooth crown area will be calculated as mesial-distal crown length multiplied by buccal-lingual width (L Χ W). Weight of individual will be recorded in grams. Height of individual will be recorded in centimeters. BMI will be calculated. Tooth crown area will be correlated with body weight and BMI.
Results: A positive relationship between total crown area and body weight as well total crown area and BMI was observed.
Conclusion: Tooth size and body size can be correlated in living human individuals. One can use the tooth crown area to predict the weight and BMI of an individual.

Background: The aim of this study is to evaluate the center of resistance (CRes) and rotation (CRot) in maxillary incisors with different levels of alveolar bone.
Subjects and Methods : In this study, the following steps were employed namely, (1) Preprocessing: The creation of geometric model, mesh generation, and boundary conditions. (2) Postprocessing: The tooth movement and determination of CRes and CRot.
Results: The results reveal that bone loss causes CRes movement toward the apex and its relative distance to the alveolar crest decreases at the same time. The study also suggested a decrease of the distance between CRes and CRot with increase of alveolar bone loss.
Conclusion: The study showed that the orthodontic forces should be kept as light as possible with a decrease in alveolar bone height. Applied force and moment magnitudes must be reduced in proportion to maintain physiologically tolerable movements with minimal damage to these supporting structures.

Background: The old concept of total-etch/dry bonding has been superseded by total-etch/wet bonding, and later on by the self-etch systems. Manufacturers have introduced single bottle systems to be used in total-etch, self-etch, or selective-etch modes under both dry and moist conditions. The aim of this study was to evaluate shear bond strengths of three different dental adhesives under dry and wet bonding conditions, using etch-and-rinse and self-etch protocols.
Materials and Methods: A total of 60 extracted human mandibular molars were decoronated perpendicular to the long axis to expose flat coronal dentin surface embedded in acrylic resin. The teeth were randomly allocated into 4 experimental groups depending on bonding agent used: Group-I: Adper™ Single Bond 2 (Wet bonding); Group-II: Adper™ Easy Bond (Dry bonding); Group-III: Single Bond Universal™ (Dry bonding); and Group-IV: Single Bond Universal™ (wet bonding), with 15 teeth per group (n = 15). Composite cylinders of 3 mm height were built and subjected to shear bond strength testing using a Universal testing machine. Data was analyzed statistically by ANOVA followed by post-hoc Tukey test.
Results: Group-I (Adper™ Single Bond 2; total-etch/wet bonding) showed the highest shear bond strength followed in order by Group-IV (Single Bond Universal™; total-etch/wet bonding); Group-III (Single Bond Universal™; self-etch/dry bonding); and Group-II (Adper™ Easy Bond; self-etch/dry bonding). Group-I (Adper™ Single Bond 2) showed statistically significant difference (P < 0.001), with higher shear bond strength than Groups - II, III or IV.
Conclusion: A higher shear bond strengths may be attained with Adper™ Single Bond 2 (Group-I) used under wet bonding conditions.

Background: The aim of the present study was to compare and evaluate the periodontal status between the Tibetan refugees settled in Karnataka and the local Indian population, i.e., Hubli-Dharwad.
Materials and Methods: In the present study, a total of 1000 subjects, 500 Indians and 500 Tibetans above the age of 18 years were examined. They were again grouped into 4 groups based on their age. Thus, oral hygiene and periodontal status were assessed by plaque index (PI) (Silness and Loe 1964), gingival index (GI) (Loe and Silness 1963), bleeding index (Muhlemann 1971), simplified oral hygiene index (OHI-S) index (Greene and Vermillion 1964), and community periodontal index of treatment needs (CPITN) index (Animo et al., for WHO 1982).
Results: Indian males and females exhibited better oral hygiene than the Tibetan's. Tibetan and Indian population with regard to various age groups, it was found that Indian population had significantly better periodontal status in all the groups. Gingival recession was seen more commonly among the Indian population when compared Tibetan population, whereas oral lesions were a more prevalent among Tibetans than Indians. Comparing various indices for periodontal status GI, sulcus bleeding index and CPITN index for the overall population between Indians and Tibetans did not show any statistically significant difference, whereas PI and OHI were statistically significant (P < 0.005).
Conclusion: The Indian population which visited the dental college for treatment purposes had better oral hygiene and periodontal status as compared to the Tibetan population.

The term amelogenesis imperfecta (AI) refers to a group of rare autosomal disorders expressed as defects in the enamel formation of teeth.1,2 The disorder is known to affect both primary and secondary teeth and may manifest with symptoms ranging from mild discoloration leading to compromised esthetics to complete mutilation of dentition leading to a loss of vertical dimension and compromised states of function.3 The restoration of vertical dimension loss in patients with enamel defects associated with AI presents a challenge for prosthodontists. Restorative treatment modalities vary from basic oral hygiene maintenance instructions to complex partial and full coverage restorations.3-5 The following case series details rehabilitation of two individuals affected by AI with completely different treatment modalities.

Background: Number of dental institutions has increased in the past decade but unfortunately none of them are running any global oral health course. So, present study was carried out to understand the interest of students in international volunteer opportunities, knowledge and attitudes of the students toward the global oral health issues, basic package of oral care (BPOC) and a need for a course on global oral health issues.
Materials and Methods: A questionnaire study was conducted in the final year students of Al-Farabi Dental College, Riyadh, Kingdom of Saudi Arabia. An amended version of the Global Oral Health Information Questionnaire was used with ten close ended questions. 210 students were asked to fill the questionnaires and out of which 197 responded and these were used for the data analysis.
Results: The data analysis suggested that 87.3% of the students who were surveyed showed strong interest to be volunteer as a dentist in an international platform or other developed country. 68% of the students do not have knowledge about the global oral health status. The need of information about the oral health care devices in developing and developed countries is essential to address global oral health issue was felt by 76.6% of the students. 83% of the students have no idea about the BPOC package and only 13% of the students were aware, who drafted BPOC.
Conclusion: The data analysis suggests the need of course on global oral health issues for the dental students. The results also suggest the students lack the knowledge on the global oral health status and policies of World Health Organization on global oral health issues including BPOC. Moreover, the results also depict the voluntariness of the student to work in an international setting.

Background: Osseointegrated implants as a foundation for the prosthetic replacement of missing teeth has become widespread in the recent time, but the success of it depends on several parameters.
Materials and Methods: The retrospective study was designed on 3260 implants patients. Various characteristics of implants and smoking habit were recorded of each patient.
Results: Out of it 3128 implants survived and 132 failed. 2610 implants were placed in men and 650 in female patients with an age range between 26 and 58 years.
Conclusion: Even though smoking is not a contraindication to dental implants but it do has a significant effect on survival of implants. Implant patients should be informed about adverse effects of tobacco.

Background: This study evaluates the fracture resistance of pulpotomized primary molars restored with Cermet, Resin modified glass-ionomer cement (GIC), and nanocomposites.
Materials and Methods: A total of 60 primary first and second molars were collected for this study. All the teeth were randomly divided into three groups (N = 20). Standard pulpotomy cavities were prepared. Teeth were air dried and the canal orifices were capped with a layer of zinc oxide eugenol. A lining of calcium hydroxide was placed over it. Cermet, Resin Modified GIC, and nanocomposite were placed in Groups I, II, and III, respectively. All the samples were then subjected to fracture strength test using the universal testing machine, and the results were statistically analyzed.
Results: All the groups were compared by ANOVA one-way test which indicated that there were statistically significant differences among the three groups with P < 0.05.
Conclusion: Nanocomposites can be considered to be a best restorative material in terms of fracture strength among Cermet and Resin modified GIC.

Background: The aim of this study was to compare the positive tested dental caries predictive factors conducted from very high human development countries (VHHDC) and not VHHDC (NVHHDC).
Methods: A comprehensive review of the available longitudinal studies on predictors of dental caries was undertaken using MEDLINE (PubMed) and Cochran database. Keywords for the search were: Dental caries, dental caries susceptibility with combination with the terms prognosis, forecasting, susceptibility, and predict*. Abstracts (n = 410) identified from an MEDLINE, and Cochrane registry and international journals. Search was screened independently by two investigators to exclude articles not in English, published prior to 2004, or containing no information on predictors of dental caries. Data from these included studies (n = 50) were extracted and compiled into evidence tables for further considerations.
Results: 50 articles were selected for data extraction. Follow-up time of the published studies was between 6 months and 27 years (median = 4.72); articles sample size ranged from 30 to 51000, and 89% articles started at childhood (before 12 years). Variables most frequently tested as caries predictors in included articles (n = 53), were: Baseline caries (46%), diet (26%), and tooth brushing habit (22%). Baseline caries was shown as the strongest single predictor in VHHDC and NVHHDC. Caregiver's education was found to be a significant predictive factor in NVHHDC in compare with VHHDC. The predictive ability of tooth brushing and diet (20%) were more significant in VHHDC.
Conclusions: Although finding predictive factors has been conducted in many VHHDC, research in the field of dental caries prediction in NVHHDC is inconclusive and insufficient as confirmed in this review. According to the various differences between these two groups of countries, it is important to develop more evidence in this field in different countries.

One-year Clinical Evaluation of a New Bleaching Product Used with and without LightJoseph Sabbagh, Layal El Masri, May El Hajj, Souheir Khafaja, Paul NahasFebruary 2016, 8(2):153-157

Background: This in-vivo study compares the outcome of vital teeth bleaching, with and without light.
Materials and Methods: A total of 40 subjects were selected based on an exclusion and inclusion criteria with a minimum shade of A2 (classical Vitapan shade guide and electronic easy shade). The subjects were split into two groups. Group 1: One session of in-office bleaching using 30% hydrogen peroxide, without light. Group 2: In-office bleaching using 30% hydrogen peroxide with light. Both groups were given prefabricated home bleaching disposable trays containing 8% hydrogen peroxide to be used for 3 days. A color stability was evaluated during a period of 1-year, at baseline initially before bleaching (T0), at 1 month (T1), 3 months (T3), 6 months (T6), and 12 months (T12). Subjects were given a sensitivity log sheet to report any sensitivity during treatment. Different statistical tests, Wilcoxon and Mann-Whitney were used to analyze the results.
Results: Teeth bleached appeared lighter when compared to baseline with and without light while when comparing the use of light to no light, no significant difference was registered.
Conclusion: The use of light is not mandatory for the success of in-office bleaching.

Aim : To study the sealing ability of Ketac silver, Ketac molar, Super- EBA, and intermediate restorative material (IRM) when used as retrograde filling materials using a dye penetration technique.
Materials and Methods : A total of 80 freshly extracted, single rooted, permanent maxillary central, and lateral incisors were selected for the study. The cleaning and shaping of the root canals were done and then obturated with gutta-percha using AH plus as root canal sealer. Apical root resection was performed. All the roots involved in this study were randomly divided into 4 groups (20 each) and retrofilled using Ketac silver (Group I), Ketac molar (Group II), Super-EBA (Group III), and IRM (Group IV). The roots were then sectioned buccolingually and were evaluated by a stereomicroscope for dye penetration at restorative-tooth interface to record the microleakage status of each group. The data were tabulated and statistically analyzed using analyses of variance test and post-hoc test of Scheffe.
Results: There was statistically significant difference in the mean dye penetration values between Group III (Super-EBA) when compared to Groups IV and I (IRM and Ketac Silver). Although Group III (Super-EBA) was better than Group II (Ketac Molar), there was no significant difference statistically between the groups.
Conclusion: Super-EBA and Ketac Molar has the superior sealing ability when compared to Ketac silver and IRM. Although Super- EBA demonstrated a better apical sealing ability compared to Ketac Molar, the difference between the materials was not statistically significant.

Background: It is difficult to identify a potential sealant with penetration depth until practically analyzed. A scanning electron microscopy (SEM) overview could better describe the internal picture of the materials sealed to the tooth surface on in vitro experimentation since it being a vital procedure for successful obturation. Hence, this study was undertaken to compare the penetration depth of three root canal sealers most commonly available viz., AH Plus® (Dentsply, New Delhi, India), Tubli- Seal™ (Kerr Dental, New Delhi, India), and Apexit® Plus (Ivoclar Vivadent, New Delhi, India) with different compositions using SEM.
Materials and Methods: A total of 30 single-rooted mandibular premolars decoronated and the canal preparation done by step back technique was used for this study. 17% of ethylenediaminetetraacetic acid (EDTA) used as final flush. Prepared specimens were divided into three groups of 10 teeth each, and different sealers were used for each group (zinc oxide eugenol-based - Tubli-Seal™, calcium hydroxide-based - Apexit® Plus, and resin-based sealer - AH Plus®). After obturation, teeth were split longitudinally and viewed under SEM.
Results: There was no statistically significant difference among the means of measured depth of penetration of AH Plus® and Apexit® Plus sealer. However, Tubli-Seal™ values projected statistically significant differences in comparison to AH Plus® and Apexit® Plus sealer. Means of measured depth of penetration of different sealers were subjected to one-way ANOVA and Duncan's multiple range test with a statistical significance at < 0.001.
Conclusion: Zinc oxide eugenol-based sealer (Tubli-Seal™) shows less depth of penetration as compared to the calcium hydroxide-based sealer (Apexit® Plus) and resin-based sealer (AH Plus®).

Since the introduction of mineral trioxide aggregate (MTA) by Torbinejad in 1993, the material has been hailed as a gold standard in pulpal treatment. In the past decade, the use of MTA for the treatment of young permanent tooth has become popular across the world. However, the material remains technique sensitive. The physical properties of the material make handling of the material difficult. Closure of a tooth with an immature apex requires complete debridement of the canal and complete orthograde plug placement. There have been recent case reports of successful apical barrier formation after incomplete orthograde filling with MTA. However, this approach is susceptible to risks of flare-up. This case report highlights the case of a 12-year-old patient with an incomplete orthograde filling of MTA which resulted in flare-up and required re-treatment. This case highlights the risks of improper placement of MTA in the canal. Despite its documented pulp regenerative properties, MTA can still not prevent re-infection in an improperly instrumented canal. The hard nature of MTA makes removal and re-treatment both complicated and expensive. It is, therefore, essential to ensure that MTA is only placed in the canal when the dentist is competent to ensure complete obturation.

Background: Radiology plays an important role in human age estimation and dental radiography being the most simple, non-destructive technique. Dental age estimation has been widely used to determine the chronological age of adolescents and young adults.
Materials and Methods: A total of 510 digital orthopantomograms of 227 females and 283 males aged between 9 and 25 years were taken, and third molar development was evaluated by Demirjian's tooth mineralization stages (statistical analysis using Mann- Whitney U test was performed to compare the differences in the mineralization stages of males and females and between maxilla and mandible). Comparison of male and females with mean stages in maxilla and mandible were done using Mann-Whitney U test. Probabilities of individuals being older than 10, 12, 14, 16, 18, 20, 22, 24 years were also estimated.
Results: Males attained formation Stage H (the apical end of the root canal is completely closed) earlier than females, whereas females attained Stage G earlier than males. Maxillary left molar developed earlier than mandibular left molar in males. 100% probability was seen in Stage H for both maxilla and mandible.
Conclusion: The Demirjian method is most reliable for age assessment using third molar mineralization stages.

Background: The purpose of the present study was to evaluate the role of platelet rich plasma (PRP) in augmenting the effects of porous hydroxyapatite (PHA) in promoting regeneration of furcated defects in mandibular molars Class II.
Materials and Methods: A total of 14 male subjects (age 38-52 years old) were included in this study. All subjects were presented with bilateral mandibular Class II furcation involvement. The split-mouth technique is utilized in an attempt to avoid individual variations. The females were also excluded to avoid their possible hidden hormonal disturbances. Clinical parameters were recorded after the initial phase of scaling and root planning. The baseline clinical measurements included periodontal pocket depth, clinical attachment level, horizontal probing depth, gingival recession and periapical radiographs. In each patient, a unilateral defect site was exposed by modified widman flap, debrided and filled with PRP combined with PHA. 1 month after healing of study site, the contralateral site was managed by M.W. flap only (control site). The same initial clinical measurements were repeated 6 months after surgery.
Results: The results showed that PHA combined with PRP induced a statistically significant improvement in the measured clinical parameters; greater than that of open debridement alone.
Conclusion: It could be concluded that regenerative periodontal surgery using the forementioned combination (PHA and PRP); could be proposed as a modality to enhance treatment outcome of mandibular furcated areas Class II involvement.

Background: As the polymerization pattern of methacrylate-based composite resins (MBCR) differs from siloran-based composite resins (SBCR) ones, the aim of present study was an evaluation of the micro-shear bond strength (μSBS) of SBCR bonded to aged MBCR after sandblasting with micro and nano abrasive particles with or without silane application.
Methods: 80 samples of MBCR were prepared by light curing. After incubation, they were thermocycled for 5000 cycles. Then, the specimens were divided into two subgroups randomly. The first group was air abraded by 50 μm particle of Al2O3 and was divided into 4 subgroups (M1, M2, M3, and M4). The second head group was air abraded by 80 nm Al2O3 and was randomly divided into four subgroups (M5, M6, M7, and M8). After etching, the surface were conditioned by methacrylate-based adhesive with (M2 and M6) or without (M1 and M5) silane coupling agent. The same procedure was done for silorane-based adhesive (M3 and M7/M4 and M8). Each MBCR group was bonded to its correspondence SBCR group, and μSBS was done on each bonded samples. The collected data were subjected to Kolmogorov-Smirnov, ANOVA, Tukey and three-way ANOVA tests by SPSS software ver.20 at 5% significance level.
Results: The results manifested significant differences among all groups (P = 0.00). Furthermore, the pattern of μSBS fracture was 100% in adhesive part in all of the groups.
Conclusion: Micro sized abrasive particles provide higher μSBS than nano ones in aged composite resins. Furthermore, the application of silane prior to adhesive resins is recommended for achieving higher μSBS.

Background: At the backdrop of the debatable role of antioxidant (AO) therapy, patients with oral premalignant lesions (OPLs) were evaluated to assess the logic behind AO t herapies.
Subjects and Methods: Oxidative stress and AO status have to be assessed in OPLs patients and compared with healthy individuals, classify into study groups which could be useful in selection of ideal patients requiring AO therapy. Total 121 subjects were included for this study n = 76 were with OPL, n = 45 were healthy controls. Serum levels of reactive oxygen species (ROS) (malondialdehyde [MDA]) and AO enzymes super oxide dismutase (SOD), catalase and glutathione peroxidase (GSH-PX) were evaluated in blood serum and grouped under levels of ROS and AO enzymes activity.
Results: In 76 OPL patients increase in the in serum (MDA) level observed along with a decrease in activity of AO enzymes, SOD, catalase, and GSH-PX in comparison to 45 healthy subjects. classification of OPL patients shown that 38.15% Group I patients did not have any significant change in oxidative stress. Group II (21.05%) patients though had enhanced stress, their AO enzymes level were normal these two groups did not require AO treatment. However, 10.5% of patients Group III had normal MDA with low AO defense and whereas 30.2% Group IV patients had an abnormality in all parameters, last two groups to be aided by AO therapy.
Conclusion: Prior valuation of the oxidative stress and AO status in the patients with OPL can be done to reduce the abuse of severe AOs medication.

Periodontitis is an inflammatory disease that causes destruction of tooth supporting tissues, characterized by multifactorial etiology with pathogenic bacteria being the primary etiologic agents that dwells the subgingival area. Local drug delivery system consists of antimicrobial dosages that produces more constant and prolonged concentration profiles within the subgingival tissue and provides better access into the periodontal pockets. It addresses the critical distress of exposing the patient to adverse effects of systemic administration. This article reviews the literature and presents novel trends such as osteoblast activators, growth factors, and herbal products in the local drug delivery system.

Background: Successes in dental root canal treatment require a complete knowledge of dental anatomy and root canal morphology. Root has a complicated morphology, and not only it differs in various teeth types but also it differs in the same type of teeth. Anatomical variations especially caused by the presence of lingual canal, which is often missed, may lead to failure in treatment. Considering the importance of canal anatomy and morphology in forming the root canal system and lack of information about the implementation of researches in Iran, we decided to employ the cone beam computed tomography (CBCT) imaging method for the evaluation of canal morphology and anatomy of mandibular incisors in defined groups of Iranian dental patients. Our goal was to improve the treatment rate by gathering more details about the diverse canal types.
Materials and Methods: 81 CBCT images were used to assess the anatomy and morphology of mandibular incisors. Extracted features from the images were used to identify the root type according to Vertucci's and Weine's classifications. A number of roots and root canals, root canal morphology, tooth position, and demographic data were recorded. Further processing and analysis of the results were achieved by Chi-square test, Fisher's exact test, and Kappa coefficient of agreement.
Results: All of the mandibular central and lateral incisors had one root. Based on Vertucci's classifications in mandibular central 63.1% were Type I, 13.1% Type II, 21.2% Type III, and 2.5% Type V and in mandibular lateral 56.9% of canals were Type I, 12.5% Type II, 28.1% Type III, and 2.5% Type V. Based on Weine's classifications in single-rooted central teeth with two canals, a significant difference was seen between male and female patients regarding canal variant (χ2 = 5.98, P = 0.050). No significant difference was seen between male and female patients regarding other parameters evaluated in this study (P > 0.050).
Conclusion: CBCT scans are effective tools for identification of root canal morphology.

Background: Restorative dentistry had shown considerable progress, leading to the development of improved tooth-colored restorative materials. The main concern regarding these refers to the durability and integrity of marginal sealing. The aim of this study was to evaluate and correlate microleakage and marginal integrity of silorane based low shrinkage posterior composite with nano-filled resin modified glass ionomer cement (RMGIC).
Materials and Methods: In this in vitro study, Class V cavity preparations were made and the specimens were divided into two equal groups. Specimens in Group I were restored with silorane based (Filtek P90)TM and Group II with nano filled RMGIC (Ketac N 100).TM Specimens were subjected to thermocycling and later sectioned using hard tissue microtome. Microleakage was evaluated under a stereomicroscope and later scanning electron microscope is used to assess the marginal adaptation. The obtained values were tabulated and subjected to statistical analysis.
Results: Silorane based composite demonstrated least microleakage with a mean score of 0.25 and the interface gap of 2.46 compared with nanoionomer with mean microleakage score of 0.44 and interface gap of 14.73, respectively.
Conclusion: Silorane based low shrinkage posterior composite (Filtek P90) exhibited adequate resistance to microleakage and better interface gap than nano-filled RMGICs. Considering the limitations of the in-vitro studies, it can be clinically correlated that Filtek P90 has better marginal properties than Ketac N 100.

Background: The study was carried out to estimate the oral hygiene status (decayed, missing, filled index [DMFT], and oral hygiene index simplified [OHI-S]), tooth brushing habits, and mucosal changes if any of institutionalized and non-institutionalized patients. Furthermore, comparison of the differences in the level of oral hygiene and mucosal changes in both groups was carried out.
Materials and Methods: The study consisted 200 psychiatric patients, out of which 100 were institutionalized in a tertiary rehabilitation center in Bangalore, and 100 were non-institutionalized. Clearance was obtained from the ethical committee, and individual consent was taken. Following this, a complete oral examination was done, and the OHI-S and DMFT were evaluated. The mucosa was examined overall with respect to the following sites: Buccal mucosa, tongue labial mucosa, floor of the mouth, and palate for mucosal changes if any. A history of tooth brushing habits was recorded from each patient.
Results: Among the 200 patients evaluated, patients diagnosed and being treated for clinical depression, schizophrenia, substance abuse, and bipolar disorders were considered for the study. The mean DMFT index was calculated to be 4.820 in institutionalized and 5.960 in non-institutionalized subjects. The mean of OHI-S was calculated to be 1.651 in institutionalized patients and 2.220 in non-institutionalized patients. There were no significant mucosal changes observed in both the classes. We also found better oral hygiene practices in the case of institutionalized patients.
Conclusion: In this study, we observed a significant increase in DMFT index in non-institutionalized patients. The OHI-S index was also found to be significant in non-institutionalized subjects. This significant increase in the parameters could be attributed to an overall care and maintenance of all aspects of the patient's health in an institution, as compared to those patients who are non-institutionalized, whose basic hygiene is often neglected.

Background: Strength, color stability, and precision of fit are requirements for all-ceramic restorations. Full zirconia has evolved to overcome the disadvantages of layered zirconia. However, marginal fit has not been evaluated so far. This original research compared the marginal vertical discrepancies of full zirconia, layered zirconia, and metal ceramic crowns and evaluated the effect of veneering on the marginal fit of zirconia copings as well as metal copings.
Materials and Methods: A total of 30 samples were used in this study. Three zirconia dies of the same dimensions were designed by computer aided designing/computer aided manufacturing (CAD/CAM) and were used to fabricate crowns in the following experimental groups: Group 1 (full zirconia); Group 2a (zirconia copings), Group 2b (layered zirconia crowns); Group 3a (metal ceramic copings) and Group 3b (metal ceramic crowns). Full crown restorations were prepared using CAD/CAM. The marginal gap was measured under a stereomicroscope. The measurement was done twice for Group 2 and Group 3 before and after veneering. The results were statistically analyzed using ANOVA test and t-test.
Results: All the three test groups showed statistically similar marginal gap, but there was a significant difference in the marginal gap between Group 3a and Group 3b.
Conclusion: The mean marginal gap of all the test groups was within the clinically acceptable level. There was no effect of veneering on the marginal fit of zirconia copings, but there was a significance of veneering on the marginal fit of metal ceramic restorations.